Clinical Effect of Hepatitis B Virus on COVID-19 Infected Patients: A Nationwide Population-Based Study Using the Health Insurance Review & Assessment Service Database.

BACKGROUND: Several studies have recently suggested that liver disease and cirrhosis were risk factors for poor outcomes in patients with coronavirus disease 2019 (COVID-19) infections. However, no large data study has reported the clinical course of COVID-19 patients with chronic hepatitis B virus (HBV) infections. This study investigated whether HBV infection had negative impacts on the clinical outcomes of COVID-19 patients. METHODS: We performed a nationwide population-based cohort study with 19,160 COVID-19-infected patients in 2020 from the Korean Health Insurance Review and Assessment database. The clinical outcomes of COVID-19 patients with chronic HBV infections were assessed and compared to those of non-HBV-infected patients. RESULTS: Of the 19,160 patients diagnosed with COVID-19, 675 (3.5%) patients had chronic HBV infections. The HBV-infected patients were older and had more commodities than the non-HBV infected COVID-19 patients. During the observation period, COVID-19-related mortality was seen in 1,524 (8.2%) of the non-HBV-infected 18,485 patients, whereas 91 (13.5%) in HBV-infected 675 patients died of COVID-19 infection. Compared to patients without HBV infections, a higher proportion of patients with chronic HBV infections required intensive care unit (ICU) admission and had organ failures. However, odds ratios for mortality, ICU admission, and organ failure were comparable between the two groups after adjusting for age, sex, and comorbid diseases including liver cirrhosis and hepatocellular carcinoma. CONCLUSION: COVID-19-infected patients with HBV infections showed worse clinical courses than non-HBV-infected COVID-19 patients. However, after adjustment, chronic HBV infection itself does not seem to affect the clinical outcomes in COVID-19 patients.

Risk of non-Hodgkin's lymphoma and thyroid cancer in primary Sjögren's syndrome measured using the Korean Health Insurance Claims Database.

OBJECTIVES: The aim of this study was to evaluate the incidence and risk of non-Hodgkin's lymphoma (NHL) and thyroid cancer in patients with primary Sjögren's syndrome (pSS) using the Korean National Health Insurance Service (NHIS) claims database. METHODS: pSS was identified using the Korean NHIS medical claims database between 2007 and 2017. The case definition required more than one visit based on the SS diagnostic code and the registration system for rare and incurable diseases. We included all admissions with a primary diagnosis of lymphoma and thyroid cancer. RESULTS: The pSS incidence was 1.88 cases/100,000 inhabitants. Female patients had a higher incidence than male patients, with a female-to-male ratio of 7.65:1. Of those, we identified 18 (0.34%), 1 (0.02%) and 29 (0.56%) patients with NHL, Hodgkin's disease and thyroid cancer, respectively. For pSS, the standardised incidence ratios for NHL and thyroid cancer were 6.32 (95% confidence interval [CI] 4.09-9.38) and 1.23 (95% CI 0.88-1.68), respectively. Compared with the general population, female patients with pSS had a 6.95-fold higher risk of developing NHL, while the male patients did not. Patients with pSS did not have a higher risk of developing thyroid cancer. CONCLUSIONS: Although pSS is associated with a higher risk of developing NHL, the risk of NHL appears to have decreased compared with that in previous studies. Our study suggests that the risk of NHL or thyroid cancer with SS is not higher than that reported in previous studies.

Incidence and Prevalence of Central Precocious Puberty in Korea: An Epidemiologic Study Based on a National Database.

OBJECTIVES: To investigate the prevalence and incidence of central precocious puberty in Korea using claims data provided by the Health Insurance Review and Assessment Service in Korea as the population-based epidemiologic study. STUDY DESIGN: In this national registry-based, longitudinal, epidemiologic study, patients who were registered with an International Classifications of Diseases, Tenth Revision diagnosis of central precocious puberty (E22.8 according to International Classifications of Diseases, Tenth Revision) and treated with gonadotropin-releasing hormone agonist were included. We assessed the age- and sex-specific prevalence and incidence rates of central precocious puberty in Korea from 2008 to 2014. RESULTS: A total of 37 890 girls and 1220 boys were newly registered with a diagnosis of central precocious puberty from 2008 to 2014. The overall incidence of central precocious puberty during the study period was 122.8 per 100 000 persons (girls, 262.8; boys, 7.0). The overall prevalence of central precocious puberty during the study period was 193.2 per 100 000 persons (girls, 410.6; boys, 10.9). The incidence and prevalence of central precocious puberty steeply increased during the study period in both girls and boys. CONCLUSIONS: This epidemiologic study, based on a national registry that included Korean children, demonstrated that the incidence and prevalence rates of central precocious puberty were high and increased steeply during the study period. Further investigations to determine the underlying causes for this rapid increase in central precocious puberty are needed.

Osteoporosis and fracture after gastrectomy for stomach cancer: A nationwide claims study.

This study was planned to evaluate the incidence and risk factors of osteoporosis and fracture after gastrectomy for stomach cancer using a nationwide claims database in South Korea.Data from 41,512 patients (50-79 years) who underwent gastrectomy for stomach cancer from 2008 to 2010 with at least 5 years of follow-up were obtained from the Health Insurance Review and Assessment Service database. Patients diagnosed with osteoporosis and prescribed bisphosphonate or raloxifene or who experienced osteoporotic fractures after gastrectomy were operationally defined as osteoporosis. Osteoporotic fracture was defined as a fracture at common osteoporotic fracture sites (spine, pelvis, hip, forearm, or rib).In total, 37,076 patients were included in the final analysis. The incidences of postgastrectomy osteoporosis and osteoporotic fractures were 41.9 and 27.6 cases per 1000 person-years, respectively. Multivariate analysis showed that older age (hazard ratio [HR] 1.88; 95% confidence interval [CI] 1.79-1.96), female gender (HR 2.46; 2.35-2.58), total gastrectomy (HR 1.10; 1.04-1.16), and diabetes (HR 1.16; 1.11-1.22) were significantly associated with osteoporosis and that older age (HR 1.90; 95% CI 1.80-2.01), female gender (HR 1.50; 1.41-1.58), total gastrectomy (HR 1.17; 1.10-1.25), chemotherapy (HR 1.06; 1.00-1.12), and diabetes (HR 1.26; 1.19-1.33) were significantly associated with fractures. Osteoporotic fractures occurred a median 3.1 years after gastrectomy. Among the 5175 fracture patients, 780 (15.1%) experienced multisite fractures, mostly in the elderly and chemotherapy groups.The osteoporosis and osteoporotic fracture incidences are high in patients within a relatively short timeframe after gastrectomy for stomach cancer. Systematic management of osteoporosis is necessary after this surgery.

Incidence of Clinically Relevant Incisional Hernia After Colon Cancer Surgery and Its Risk Factors: A Nationwide Claims Study.

BACKGROUND: As there is scant literature focusing on incisional hernia for which hospital care is sought, the aim of this study was to elucidate the incidence and risk factors of overt incisional hernia (OIH) after colon cancer surgery using nationwide claims data. METHODS: Claims data of colon cancer patients who underwent regional colectomy were obtained from the Health Insurance Review and Assessment Service database of South Korea. Data from 2010 to 2012 were collected to ensure adequate follow-up. OIH was considered to be present when either the diagnosis code for IH or the claim code for IH repair was entered after index colectomy for colon cancer. RESULTS: A total of 24,645 patients underwent regional colectomy for colon cancer during the study period. Of these, 376 (1.5%) patients had an OIH within 3 years after surgery, and 50.3% of OIHs developed within the first year after the index colectomy (883.7 cases/10,000 patient-years). The Cox proportional hazard model showed that age >65 years, female gender, open colectomy, and institution volume <100 colectomies per year were statistically significant risk factors for OIH. The 3-year cumulative OIH incidence rates according to age >65 years, female gender, open colectomy, and institution volume <100 colectomies per year were 2.1, 2.1, 2.0, and 2.1%, respectively. CONCLUSIONS: Several risk factors for OIH and its incidence after regional colectomy for colon cancer were identified. These findings are helpful for classifying patients undergoing segmental colectomy who have increased the likelihood of developing IH and are informative for patients and medical providers performing the surgery.

Epidemiologic Study on Kawasaki Disease in Korea, 2007-2014: Based on Health Insurance Review & Assessment Service Claims.

The aim of this study is to assess the actual epidemiologic features of Kawasaki disease (KD) in Korea using the data from Health Insurance Review & Assessment Service (HIRA) claims from 2007 to 2014. We investigated HIRA claims of patients who had KD (International Classification of Diseases-10, M30.3) as a major diagnosis and were given intravenous immunoglobulin (IVIG) from 2007 to 2014. A total of 39,082 patients were reported during the period. The male-to-female ratio was 1.42 and the median age was 28 months. The incidence rates were 168.3 per 100,000 population aged 0 to 4 years in 2007, 159.1 in 2008, 167.3 in 2009, 190.4 in 2010, 188.2 in 2011, 190.2 in 2012, 210.4 in 2013 and 217.2 in 2014. These rates were much higher than those in the previous studies in Korea. KD occurred more often in early summer (May, June and July) and winter (December and January). The annual incidence rate of KD had been increasing every year, reaching 217.2 per 100,000 population aged 0 to 4 years in 2014. It is the second highest incidence rate of KD in the world after Japan.

Incidence and Prevalence of Overt Hypothyroidism and Causative Diseases in Korea as Determined Using Claims Data Provided by the Health Insurance Review and Assessment Service.

BACKGROUND: The incidence and prevalence of overt hypothyroidism have been reported to be 2 to 4/1,000 population/year and 8 to 13/1,000 population, respectively, in foreign countries. As there has been no nationwide survey to obtain data in Korea, the present study investigated the incidence and prevalence of overt hypothyroidism in Korea using claims data provided by the Health Insurance Review and Assessment Service. The proportions of causative diseases for hypothyroidism were also analyzed. METHODS: This study was retrospectively performed with 541,969 Korean patients (92,832 men and 449,137 women), with overt hypothyroidism, treated with thyroid hormone between 2008 and 2012. RESULTS: The incidence of overt hypothyroidism in Korea was 2.26/1,000 population/year (0.78 in men and 3.72 in women), and the prevalence was 14.28/1,000 population (4.40 in men and 24.03 in women). When patients with thyroid cancer were excluded, the incidence was 1.56/1,000 population/year (0.54 in men and 2.57 in women). The incidence increased with age, with peaks in and after the late 60s in men and in the early 50s in women. The prevalence peaked in the early 70s in men and in the late 50s in women. CONCLUSION: This is a report of the first nationwide investigation of the incidence and prevalence of overt hypothyroidism in Korea, although it is limited to patients treated with thyroid hormone.